﻿<%@ Control Language="C#" ClassName="NewRevenueVnFields" %>

<asp:FormView ID="FormView1" runat="server">
	<ItemTemplate>
		<table border="0" cellpadding="3" cellspacing="1">
			<tr>
        <td class="literal"><asp:Label ID="lbldataCmsCenter" runat="server" Text="Cms Center:" AssociatedControlID="dataCmsCenter" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataCmsCenter" Text='<%# Bind("CmsCenter") %>' MaxLength="10"></asp:TextBox><asp:RequiredFieldValidator ID="ReqVal_dataCmsCenter" runat="server" Display="Dynamic" ControlToValidate="dataCmsCenter" ErrorMessage="Required"></asp:RequiredFieldValidator>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataInvNber" runat="server" Text="Inv Nber:" AssociatedControlID="dataInvNber" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataInvNber" Text='<%# Bind("InvNber") %>' MaxLength="5"></asp:TextBox><asp:RequiredFieldValidator ID="ReqVal_dataInvNber" runat="server" Display="Dynamic" ControlToValidate="dataInvNber" ErrorMessage="Required"></asp:RequiredFieldValidator>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataDateVisit" runat="server" Text="Date Visit:" AssociatedControlID="dataDateVisit" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataDateVisit" Text='<%# Bind("DateVisit", "{0:d}") %>' MaxLength="10"></asp:TextBox><asp:ImageButton ID="cal_dataDateVisit" runat="server" SkinID="CalendarImageButton" OnClientClick="javascript:showCalendarControl(this.previousSibling);return false;" /><asp:RequiredFieldValidator ID="ReqVal_dataDateVisit" runat="server" Display="Dynamic" ControlToValidate="dataDateVisit" ErrorMessage="Required"></asp:RequiredFieldValidator>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataPatFilcod" runat="server" Text="Pat Filcod:" AssociatedControlID="dataPatFilcod" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataPatFilcod" Text='<%# Bind("PatFilcod") %>' MaxLength="6"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataPatName" runat="server" Text="Pat Name:" AssociatedControlID="dataPatName" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataPatName" Text='<%# Bind("PatName") %>' MaxLength="16"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataPatFName" runat="server" Text="Pat F Name:" AssociatedControlID="dataPatFName" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataPatFName" Text='<%# Bind("PatFName") %>' MaxLength="16"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataPatNatio" runat="server" Text="Pat Natio:" AssociatedControlID="dataPatNatio" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataPatNatio" Text='<%# Bind("PatNatio") %>' MaxLength="16"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataPatCodcrp" runat="server" Text="Pat Codcrp:" AssociatedControlID="dataPatCodcrp" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataPatCodcrp" Text='<%# Bind("PatCodcrp") %>' MaxLength="4"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataJobCorp" runat="server" Text="Job Corp:" AssociatedControlID="dataJobCorp" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataJobCorp" Text='<%# Bind("JobCorp") %>' MaxLength="100"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataTotalProc" runat="server" Text="Total Proc:" AssociatedControlID="dataTotalProc" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataTotalProc" Text='<%# Bind("TotalProc") %>'></asp:TextBox><asp:RangeValidator ID="RangeVal_dataTotalProc" runat="server" Display="Dynamic" ControlToValidate="dataTotalProc" ErrorMessage="Invalid value" MaximumValue="999999999" MinimumValue="-999999999" Type="Double"></asp:RangeValidator>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataTotalPhar" runat="server" Text="Total Phar:" AssociatedControlID="dataTotalPhar" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataTotalPhar" Text='<%# Bind("TotalPhar") %>'></asp:TextBox><asp:RangeValidator ID="RangeVal_dataTotalPhar" runat="server" Display="Dynamic" ControlToValidate="dataTotalPhar" ErrorMessage="Invalid value" MaximumValue="999999999" MinimumValue="-999999999" Type="Double"></asp:RangeValidator>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataTotalPay" runat="server" Text="Total Pay:" AssociatedControlID="dataTotalPay" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataTotalPay" Text='<%# Bind("TotalPay") %>'></asp:TextBox><asp:RangeValidator ID="RangeVal_dataTotalPay" runat="server" Display="Dynamic" ControlToValidate="dataTotalPay" ErrorMessage="Invalid value" MaximumValue="999999999" MinimumValue="-999999999" Type="Double"></asp:RangeValidator>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataFlagRev" runat="server" Text="Flag Rev:" AssociatedControlID="dataFlagRev" /></td>
        <td>
					<asp:RadioButtonList runat="server" ID="dataFlagRev" SelectedValue='<%# Bind("FlagRev") %>' RepeatDirection="Horizontal"><asp:ListItem Value="True" Text="Yes" Selected="True"></asp:ListItem><asp:ListItem Value="False" Text="No"></asp:ListItem><asp:ListItem Value="" Text="Pick ..." Enabled="False"></asp:ListItem></asp:RadioButtonList>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataInvStat" runat="server" Text="Inv Stat:" AssociatedControlID="dataInvStat" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataInvStat" Text='<%# Bind("InvStat") %>' MaxLength="2"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataRateCurr" runat="server" Text="Rate Curr:" AssociatedControlID="dataRateCurr" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataRateCurr" Text='<%# Bind("RateCurr") %>'></asp:TextBox><asp:RangeValidator ID="RangeVal_dataRateCurr" runat="server" Display="Dynamic" ControlToValidate="dataRateCurr" ErrorMessage="Invalid value" MaximumValue="999999999" MinimumValue="-999999999" Type="Double"></asp:RangeValidator>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataVatAmount" runat="server" Text="Vat Amount:" AssociatedControlID="dataVatAmount" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataVatAmount" Text='<%# Bind("VatAmount") %>'></asp:TextBox><asp:RangeValidator ID="RangeVal_dataVatAmount" runat="server" Display="Dynamic" ControlToValidate="dataVatAmount" ErrorMessage="Invalid value" MaximumValue="999999999" MinimumValue="-999999999" Type="Double"></asp:RangeValidator>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataSrvAmount" runat="server" Text="Srv Amount:" AssociatedControlID="dataSrvAmount" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataSrvAmount" Text='<%# Bind("SrvAmount") %>'></asp:TextBox><asp:RangeValidator ID="RangeVal_dataSrvAmount" runat="server" Display="Dynamic" ControlToValidate="dataSrvAmount" ErrorMessage="Invalid value" MaximumValue="999999999" MinimumValue="-999999999" Type="Double"></asp:RangeValidator>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataUpdPayAcctcode" runat="server" Text="Upd Pay Acctcode:" AssociatedControlID="dataUpdPayAcctcode" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataUpdPayAcctcode" Text='<%# Bind("UpdPayAcctcode") %>' MaxLength="15"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataUpdInvMode" runat="server" Text="Upd Inv Mode:" AssociatedControlID="dataUpdInvMode" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataUpdInvMode" Text='<%# Bind("UpdInvMode") %>' MaxLength="6"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataUpdInvStat" runat="server" Text="Upd Inv Stat:" AssociatedControlID="dataUpdInvStat" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataUpdInvStat" Text='<%# Bind("UpdInvStat") %>' MaxLength="6"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataUpdVatNum" runat="server" Text="Upd Vat Num:" AssociatedControlID="dataUpdVatNum" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataUpdVatNum" Text='<%# Bind("UpdVatNum") %>' MaxLength="5"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataUpdVatCenter" runat="server" Text="Upd Vat Center:" AssociatedControlID="dataUpdVatCenter" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataUpdVatCenter" Text='<%# Bind("UpdVatCenter") %>' MaxLength="5"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataUpdPaymentDate" runat="server" Text="Upd Payment Date:" AssociatedControlID="dataUpdPaymentDate" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataUpdPaymentDate" Text='<%# Bind("UpdPaymentDate", "{0:d}") %>' MaxLength="10"></asp:TextBox><asp:ImageButton ID="cal_dataUpdPaymentDate" runat="server" SkinID="CalendarImageButton" OnClientClick="javascript:showCalendarControl(this.previousSibling);return false;" />
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataUpdSunImport" runat="server" Text="Upd Sun Import:" AssociatedControlID="dataUpdSunImport" /></td>
        <td>
					<asp:RadioButtonList runat="server" ID="dataUpdSunImport" SelectedValue='<%# Bind("UpdSunImport") %>' RepeatDirection="Horizontal"><asp:ListItem Value="True" Text="Yes" Selected="True"></asp:ListItem><asp:ListItem Value="False" Text="No"></asp:ListItem><asp:ListItem Value="" Text="Pick ..." Enabled="False"></asp:ListItem></asp:RadioButtonList>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataUpdReason" runat="server" Text="Upd Reason:" AssociatedControlID="dataUpdReason" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataUpdReason" Text='<%# Bind("UpdReason") %>' MaxLength="80"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataUpdReasonType" runat="server" Text="Upd Reason Type:" AssociatedControlID="dataUpdReasonType" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataUpdReasonType" Text='<%# Bind("UpdReasonType") %>' MaxLength="30"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataUpdRemark" runat="server" Text="Upd Remark:" AssociatedControlID="dataUpdRemark" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataUpdRemark" Text='<%# Bind("UpdRemark") %>' MaxLength="50"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataUpdStatCat" runat="server" Text="Upd Stat Cat:" AssociatedControlID="dataUpdStatCat" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataUpdStatCat" Text='<%# Bind("UpdStatCat") %>' MaxLength="1"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataUpdSunImportDate" runat="server" Text="Upd Sun Import Date:" AssociatedControlID="dataUpdSunImportDate" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataUpdSunImportDate" Text='<%# Bind("UpdSunImportDate", "{0:d}") %>' MaxLength="10"></asp:TextBox><asp:ImageButton ID="cal_dataUpdSunImportDate" runat="server" SkinID="CalendarImageButton" OnClientClick="javascript:showCalendarControl(this.previousSibling);return false;" />
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataDiagCode" runat="server" Text="Diag Code:" AssociatedControlID="dataDiagCode" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataDiagCode" Text='<%# Bind("DiagCode") %>' MaxLength="7"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataAeaProgr" runat="server" Text="Aea Progr:" AssociatedControlID="dataAeaProgr" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataAeaProgr" Text='<%# Bind("AeaProgr") %>' MaxLength="15"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataPatRefer" runat="server" Text="Pat Refer:" AssociatedControlID="dataPatRefer" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataPatRefer" Text='<%# Bind("PatRefer") %>' MaxLength="40"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataUpdCaseFileNum" runat="server" Text="Upd Case File Num:" AssociatedControlID="dataUpdCaseFileNum" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataUpdCaseFileNum" Text='<%# Bind("UpdCaseFileNum") %>' MaxLength="50"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataPatSex" runat="server" Text="Pat Sex:" AssociatedControlID="dataPatSex" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataPatSex" Text='<%# Bind("PatSex") %>' MaxLength="1"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataPatDob" runat="server" Text="Pat Dob:" AssociatedControlID="dataPatDob" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataPatDob" Text='<%# Bind("PatDob", "{0:d}") %>' MaxLength="10"></asp:TextBox><asp:ImageButton ID="cal_dataPatDob" runat="server" SkinID="CalendarImageButton" OnClientClick="javascript:showCalendarControl(this.previousSibling);return false;" />
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataWinisNo" runat="server" Text="Winis No:" AssociatedControlID="dataWinisNo" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataWinisNo" Text='<%# Bind("WinisNo") %>' MaxLength="6"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataWinisPrgr" runat="server" Text="Winis Prgr:" AssociatedControlID="dataWinisPrgr" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataWinisPrgr" Text='<%# Bind("WinisPrgr") %>' MaxLength="20"></asp:TextBox>
				</td>
			</tr>
			<tr>
        <td class="literal"><asp:Label ID="lbldataCompTel2" runat="server" Text="Comp Tel2:" AssociatedControlID="dataCompTel2" /></td>
        <td>
					<asp:TextBox runat="server" ID="dataCompTel2" Text='<%# Bind("CompTel2") %>' MaxLength="16"></asp:TextBox>
				</td>
			</tr>
			
		</table>

	</ItemTemplate>
</asp:FormView>


